Inspection on 03/11/05 for Park View (Streatham)

This inspection was carried out on 3rd November 2005.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Good. The way we rate inspection reports is consistent for all houses, though please be aware that this may be different from an official CSCI judgement.

The inspector found there to be outstanding requirements from the previous inspection report. These are things the inspector asked to be changed, but found they had not done. The inspector also made 10 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Park View (Streatham) 22/08/07

Park View (Streatham) 16/05/06

Park View (Streatham) 19/05/05

Park View (Streatham) 13/01/05

Park View (Streatham) 13/10/04

Park View (Streatham) 11/02/04

Extracts from inspection reports are licensed from CQC, this page was updated on 09/07/2008.

CARE HOME ADULTS 18-65 Park View (Streatham) 17 Streatham Common South Streatham London SW16 3BU Lead Inspector Sonia McKay Unannounced Inspection 3rd November 2005 08:30 DS0000022747.V256597.R01.S.doc Version 5.0 Page 1 The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address DS0000022747.V256597.R01.S.doc Version 5.0 Page 2 This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Adults 18-65. They can be found at www.dh.gov.uk or obtained from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. DS0000022747.V256597.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION Name of service Park View (Streatham) Address 17 Streatham Common South Streatham London SW16 3BU 0208-679-2364 Telephone number Fax number Email address Provider Web address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) crownwise@yahoo.com Crown Wise Limited Mr Allen Amuaku Care Home 18 Category(ies) of Mental disorder, excluding learning disability or registration, with number dementia (0), Mental Disorder, excluding of places learning disability or dementia - over 65 years of age (0) DS0000022747.V256597.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION Conditions of registration: 1. up to two persons only aged 65 years and above Date of last inspection 19th May 2005 Brief Description of the Service: Parkview is a private residential home for eighteen adults with mental health issues. It is one of three homes in the locality owned by the same proprietor. The home is in a residential street overlooking Streatham Common, within walking distance of transport links, shops and leisure facilities. It is located in a large house and is decorated and furnished to a good standard. The majority of service users have been at the home for many years and the home aims to provide them with the various degrees of support. Where appropriate, the home also helps to prepare service users for independent living. DS0000022747.V256597.R01.S.doc Version 5.0 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This unannounced inspection was carried out in six hours over one day. It involved talking with the home manager, two members of staff and six of the service users. Records relating to care, support and health and the safety of the premises were examined. What the service does well: What has improved since the last inspection? What they could do better: Recruitment practices must be stringently followed to ensure that service users are protected. There must be better assessment of service users needs before they are admitted to the home. Care plans must describe how service users wish to be supported with their personal care. DS0000022747.V256597.R01.S.doc Version 5.0 Page 6 The manager and staff must seek further advice on communicating with a service user who is non-verbal. More staff must undertake to complete a vocational qualification in care and the home manager must complete care management training. The manager must develop a quality assurance system that involves continuous self-monitoring and the views of all stakeholders. Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. DS0000022747.V256597.R01.S.doc Version 5.0 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–5) Individual Needs and Choices (Standards 6-10) Lifestyle (Standards 11-17) Personal and Healthcare Support (Standards 18-21) Concerns, Complaints and Protection (Standards 22-23) Environment (Standards 24-30) Staffing (Standards 31-36) Conduct and Management of the Home (Standards 37 – 43) Scoring of Outcomes Statutory Requirements Identified During the Inspection DS0000022747.V256597.R01.S.doc Version 5.0 Page 8 Choice of Home The intended outcomes for Standards 1 – 5 are: 1. 2. 3. 4. 5. Prospective service users have the information they need to make an informed choice about where to live. Prospective users’ individual aspirations and needs are assessed. Prospective service users know that the home that they will choose will meet their needs and aspirations. Prospective service users have an opportunity to visit and to “test drive” the home. Each service user has an individual written contract or statement of terms and conditions with the home. The Commission consider Standard 2 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 2, 3, 4 & 5. A service user has moved into the home without adequate needs assessment. Although the service user had opportunity to visit the home before moving in, the placement provided is in breach of the home’s conditions of registration. EVIDENCE: A service user, who previously lived in another home in the area owned by the same proprietor, has moved into Parkview since the last inspection visit. This resettlement has been completed without adequate pre-admission assessment and negotiation with the placing authority. The service user had been admitted to hospital after a fall and the previous placement could not meet increased mobility needs. (See requirement 1). The service user is over the age of 65. The home is registered to accommodate only two service users above this age and both of these conditional placements are currently occupied. This admission is therefore in breach of the conditions of registration. (See requirement 2). The service user confirmed that she knew the home well and had visited many times before moving in. The occupancy contract between the service user and the home includes an initial care plan and details of the arrangements in place for reviewing the plan, as required in the previous inspection report. DS0000022747.V256597.R01.S.doc Version 5.0 Page 9 Individual Needs and Choices The intended outcomes for Standards 6 – 10 are: 6. 7. 8. 9. 10. Service users know their assessed and changing needs and personal goals are reflected in their individual Plan. Service users make decisions about their lives with assistance as needed. Service users are consulted on, and participate in, all aspects of life in the home. Service users are supported to take risks as part of an independent lifestyle. Service users know that information about them is handled appropriately, and that their confidences are kept. The Commission considers Standards 6, 7 and 9 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 6, 7, 8 & 9. Service users individual care plans must include detailed information about communication and personal care. There is a need to develop strategies to enable better communication for one service user. Service users are supported to take risks as part of an independent lifestyle where possible and they are consulted on, and participate in, aspects of life in the home. EVIDENCE: Each service user has an allocated key worker who is responsible for meeting with the service user on a regular basis and updating the care plan. Care plans are reviewed regularly and are in accordance with decisions made in the care programme approach (CPA) meetings also held for the majority of service users. Some service users need considerable support with communication and personal care. Although there is improvement in documenting these specific needs, more must be done to ensure that staff have sufficient written information to enable them to support service users effectively, consistently and as the service user themselves prefers. (See requirement 3) DS0000022747.V256597.R01.S.doc Version 5.0 Page 10 One service user predominantly uses non-verbal communication. Although staff know the service user well there are no aids to communication in use. This reduces the service users opportunity to communicate his wishes. (See requirement 4) The majority of service users are able to manage their own finances. Two service users require staff support. Individual financial records are kept and checked by the home manager. Two members of staff sign for each expenditure and purchase receipts are retained. Service user group meetings are held on a regular basis. Service users said that the meetings are used to decide on group leisure activities and discuss house issues. The manager uses questionnaires to obtain the views of service users on issues relating to the service provided. Feedback is given during house meetings and one-to-one sessions with individual service users. Individual plans contain a general risk assessment. Individual procedures are in place for service users who are likely to cause harm to themselves or others based on the outcomes of the general risk assessment tool and CPA review decisions as appropriate. Missing persons procedures are in place along with a photograph of each service user. DS0000022747.V256597.R01.S.doc Version 5.0 Page 11 Lifestyle The intended outcomes for Standards 11 - 17 are: 11. 12. 13. 14. 15. 16. 17. Service users have opportunities for personal development. Service users are able to take part in age, peer and culturally appropriate activities. Service users are part of the local community. Service users engage in appropriate leisure activities. Service users have appropriate personal, family and sexual relationships. Service users’ rights are respected and responsibilities recognised in their daily lives. Service users are offered a healthy diet and enjoy their meals and mealtimes. The Commission considers Standards 12, 13, 15, 16 and 17 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 14 & 15. Service users engage in appropriate leisure activities but do not have access to an annual holiday. Service users are able to maintain appropriate personal relationships. EVIDENCE: A range of leisure activities, including day trips to the seaside, is available. However, annual holidays are not part of the package of care provided by the home. The registered provider and home manager are in discussion with placing authorities about this, as there are funding implications. (See recommendation 1) Service users have an opportunity to attend a social gathering each week in the home, and the home manager has purchased a movie projector and screen for regular movie nights. Television reception has improved since the last inspection but is still inadequate in some areas. (See recommendation 2) Service users are able to maintain family links and friendships outside the home themselves in most cases. Family and friends are welcomed to the home and invited to activities, like house barbecues, if the service user DS0000022747.V256597.R01.S.doc Version 5.0 Page 12 themselves wishes. Service users can see their visitors in the privacy of their own rooms. The home manager said that service users are able to develop and maintain intimate personal relationships with people of their choice and that overnight guests could be accommodated on request. DS0000022747.V256597.R01.S.doc Version 5.0 Page 13 Personal and Healthcare Support The intended outcomes for Standards 18 - 21 are: 18. 19. 20. 21. Service users receive personal support in the way they prefer and require. Service users’ physical and emotional health needs are met. Service users retain, administer and control their own medication where appropriate, and are protected by the home’s policies and procedures for dealing with medicines. The ageing, illness and death of a service user are handled with respect and as the individual would wish. The Commission considers Standards 18, 19, and 20 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 18 & 19. The nature and extent of the personal support required by each service user is inadequately documented. Service users physical and emotional health needs are addressed and met. EVIDENCE: Some service users require support with personal care. Although the need for this support is noted, the nature and extent of the support required is not detailed in individual care plans. (See requirement 3) Each service user has a detailed record of health care provided. The three records examined during this inspection showed that a range of appropriate health care professionals are actively involved in the care of each service user. DS0000022747.V256597.R01.S.doc Version 5.0 Page 14 Concerns, Complaints and Protection The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 22 & 23. Service users are protected from abuse, neglect and self-harm and their views are listened to and acted on. EVIDENCE: There is a clear and effective complaints procedure in place. There have been no complaints since the last inspection visit. Service users said that they felt able to raise concerns and complaints either directly to staff or to the home manager and that where possible action is taken to address these concerns immediately. Staff are trained in abuse awareness and challenging behaviour and adequate safeguards are in place to protect service users from abuse, neglect and selfharm. DS0000022747.V256597.R01.S.doc Version 5.0 Page 15 Environment The intended outcomes for Standards 24 – 30 are: 24. 25. 26. 27. 28. 29. 30. Service users live in a homely, comfortable and safe environment. Service users’ bedrooms suit their needs and lifestyles. Service users’ bedrooms promote their independence. Service users’ toilets and bathrooms provide sufficient privacy and meet their individual needs. Shared spaces complement and supplement service users’ individual rooms. Service users have the specialist equipment they require to maximise their independence. The home is clean and hygienic. The Commission considers Standards 24, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 24, 25, 26, 27, 28, 29 & 30. Service users live in a homely, comfortable and safe environment. Toilets and bathrooms provide sufficient privacy and communal areas compliment and supplement service users individual rooms. The number of shared bedrooms has decreased and this has improved the accommodation for individual service users. There is no evidence that the home can provide suitable and safe accommodation for one service user with a physical mobility need. EVIDENCE: The home is clean, well furnished and decorated. There is a ground floor communal dining room that is also used for social activities. There are two communal lounges, both with roof terraces. One lounge is a dedicated no smoking area. There are front and back garden paved areas with shrub planting, hanging baskets and seating. The home manager said that the programme of cyclical redecoration is ongoing. There is good access to local amenities, services and transport links. The home overlooks Streatham common. Service users said that they enjoy the close access to this open space in good weather. There are 14 single bedrooms and two double bedrooms. Since the last inspection visit one double bedroom has been reduced to single occupancy (as a result of a service user moving to his own flat). The home manager said that DS0000022747.V256597.R01.S.doc Version 5.0 Page 16 the home now accommodates only 17 service users. Service users said that they were satisfied with their bedroom accommodation. Eight bedrooms have en-suite facilities. There are twelve shower facilities, two bathrooms, and fifteen toilets. There is a communal laundry in the basement. Although there are four bedrooms situated on the ground floor the home is not suitable for service users with a physical mobility need as the only accessible communal area is the ground floor dining room. The service user most recently admitted to the home has a mobility need. An occupational therapy assessment has been requested by the home manager and the placing authority are awaiting the results of this report before deciding on the suitability of the placement. (See requirements 1 & 2). DS0000022747.V256597.R01.S.doc Version 5.0 Page 17 Staffing The intended outcomes for Standards 31 – 36 are: 31. 32. 33. 34. 35. 36. Service users benefit from clarity of staff roles and responsibilities. Service users are supported by competent and qualified staff. Service users are supported by an effective staff team. Service users are supported and protected by the home’s recruitment policy and practices. Service users’ individual and joint needs are met by appropriately trained staff. Service users benefit from well supported and supervised staff. The Commission considers Standards 32, 34 and 35 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 31, 32, 33, 34, 35 & 36. Service users benefit from clarity of staff roles and responsibilities. There has been progress in developing a suitable training programme for staff working in the home although more staff must achieve a vocational qualification. Service users are not adequately protected by the recruitment practices. EVIDENCE: Staff have clearly defined job descriptions and understand their own and others roles and responsibilities. A regular pool of bank staff are used to cover sickness and annual leave. This gives service users an opportunity to get to know staff well. Staff are supplied with the General Social Care Council code of conduct as part of their induction. Service users were observed to approach staff with ease and to interact well with them. A service user said, The staff here are good and confirmed that staff treated the service users with care and respect. The home manager supplied the CSCI with staff training information. Only five of the 17 care staff have achieved an NVQ level 2 or above. This is less than the minimum 50 required. (See requirement 5) DS0000022747.V256597.R01.S.doc Version 5.0 Page 18 A training and development programme shows that training in a range of appropriate topics has been provided in 2005. However, only four members of staff hold a current first aid certificate. This is inadequate and does not provide service users with the required level of safety. (See requirement 6) The home manager has compiled individual staff training records. This enables the manager to monitor staff training needs. Staffing levels were reviewed as required in the previous inspection report. Staffing levels have been increased by eight hours per day of one-to-one support for a service user as a result. Staff duty rotas show that a sufficient number of staff are now on duty. The home is on target to achieve the minimum of six staff team meetings held in each year. Three members of staff have resigned since the last inspection visit. Discussion with the home manager indicated that staff pay rates may have been a factor in their decision to leave. (See recommendation 3). Two members of staff have been recruited since the last inspection visit. Recruitment records showed that one member of staff did not have a POVA First or CRB check. An immediate requirement was issued. The registered person provided the CSCI with evidence of a satisfactory POVA First check two days after the inspection. (See requirement 7) Staff supervision meetings are conducted with the required frequency. The home manager meets with each member of staff on a regular basis to discuss key working issues and individual performance. DS0000022747.V256597.R01.S.doc Version 5.0 Page 19 Conduct and Management of the Home The intended outcomes for Standards 37 – 43 are: 37. 38. 39. 40. 41. 42. 43. Service users benefit from a well run home. Service users benefit from the ethos, leadership and management approach of the home. Service users are confident their views underpin all self-monitoring, review and development by the home. Service users’ rights and best interests are safeguarded by the home’s policies and procedures. Service users’ rights and best interests are safeguarded by the home’s record keeping policies and procedures. The health, safety and welfare of service users are promoted and protected. Service users benefit from competent and accountable management of the service. The Commission considers Standards 37, 39, and 42 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 37, 39, 40, 41 & 42. The home manager is competent and well organised but must complete formal training in care management. The views of service users are obtained as part of the homes self monitoring. Policies and procedures are in place and are reviewed regularly. Service users rights and best interests are safeguarded by the homes record-keeping and their health, safety and welfare is promoted and protected. EVIDENCE: The registered manager has a medical qualification and is competent and experienced. He has not completed a care or management qualification. (See requirement 8). There is good compliance with requirements made in the previous CSCI inspection report and service users are provided with a copy of the report if they wish. However, the home’s conditions of registration have been breached as a result of a recent admission to the service. The home manager is introducing quality monitoring systems, based on seeking the views of service users. Service users receive feedback from this DS0000022747.V256597.R01.S.doc Version 5.0 Page 20 monitoring. These systems should be further developed to effectively monitor the quality of the services provided in the home and to include the views of all stakeholders on how the home is achieving goals for service users. (See requirement 9). There is an annual development plan for the home. Staff have access to up-to-date copies of all policies and procedures and codes of practice. The registered manager reviews the policies and procedures on a regular basis and is making good progress in ensuring that all policies and procedures required by the national minimum standards for care homes are in place. Records required by regulation for the protection of service users and for the effective and efficient running of the business are maintained, up-to-date and accurate. Service users have access to their records and information held by the home. Individual records and home records are secure and kept in accordance with the Data Protection Act 1998. Measures to ensure the health and safety of service users, staff and visitors are in place. Records show that: • Gas appliances had been safety tested in April 2005 • Fixed electrical wiring had been safety tested in October 2004 • Small electrical appliances had been safety tested in November 2005 • Fire authorities inspected the premises in February 2005. • Fire evacuation drills are conducted with the required frequency • Fire safety equipment is professionally tested on a regular basis • Fire safety equipment is tested by staff on a regular basis • Fire procedures are available and posted in prominent areas of the home • Hot water temperatures are checked on a weekly basis • The supplying pharmacist conducts regular inspections These records also show that: • In-house checks on emergency lighting are not completed. Advice should be sought on how often these tests should be done (See recommendation 4) • Hot water temperatures are too low in some areas (See recommendation 5) Employers liability insurance is in place. DS0000022747.V256597.R01.S.doc Version 5.0 Page 21 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Adults 18-65 have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME CONCERNS AND COMPLAINTS Standard No 1 2 3 4 5 Score X 1 1 3 3 Standard No 22 23 Score 3 3 ENVIRONMENT INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score 2 2 3 3 X Standard No 24 25 26 27 28 29 30 STAFFING Score 3 3 3 3 3 1 3 LIFESTYLES Standard No Score 11 X 12 X 13 X 14 2 15 3 16 X 17 Standard No 31 32 33 34 35 36 Score 3 2 3 2 3 3 CONDUCT AND MANAGEMENT OF THE HOME X PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 2 3 X X Standard No 37 38 39 40 41 42 43 Score 2 X 2 3 3 3 X DS0000022747.V256597.R01.S.doc Version 5.0 Page 22 Yes Are there any outstanding requirements from the last inspection? STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1 Standard YA2 Regulation 14(1) 12 Requirement Timescale for action 30/11/05 2 YA3 14(1) 12 3 YA18YA6 15(1)(2) 12 The registered person must ensure that new service users are admitted only on the basis of a full assessment undertaken by people competent to do so, involving the prospective service user, using an appropriate communication method and with an independent advocate as appropriate. The registered person must 30/12/05 demonstrate the home’s capacity to meet the assessed needs (including specialist needs) of individuals admitted to the home. The registered person must 31/01/06 develop and agree with each service user an individual Plan which includes treatment and rehabilitation, describing the services and facilities to be provided by the home, and how these services will meet current and changing needs and aspirations and achieve goals. Plans must clearly describe the support required with communication and DS0000022747.V256597.R01.S.doc Version 5.0 Page 23 4 YA7 5 YA32 6 YA32 7 YA34 8 YA37 9 YA39 personal care to enable staff to provide sensitive and flexible personal support and maximise service users’ privacy, dignity, independence and control over their lives. 12(2)(3)(4)(a) The registered person must ensure that staff respect service users’ right to make decisions, and that right is limited only through the assessment process, involving the service user, and as recorded in the individual Service User Plan. Professional advice must be sought on strategies to enable a service user with communication needs to make decisions effectively. 18(1) The registered person must ensure that plans are in place to ensure that an appropriate number of care staff are working towards a Care N.V.Q at level 2 or 3. 12(1) The registered person must 18(1) ensure that qualified first aid trained staff are available at all times in the home. 19(4) The registered person must ensure that staff are not employed in the home before recruitment checks are completed. Immediate requirement. 10(3) The registered person must ensure that the registered home manager undertakes appropriate training in NVQ level 4 and the Registered Managers Award, or equivalent courses. Within timescale of the previous requirement. 24(1) The registered person must ensure that effective quality DS0000022747.V256597.R01.S.doc 19/01/06 31/12/05 28/02/06 03/11/05 31/12/05 30/03/06 Version 5.0 Page 24 assurance and quality monitoring systems, based on seeking the views of service users and other stakeholders, are in place to measure success in achieving the aims, objectives and statement of purpose of the home. RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1 2 3 4 5 Refer to Standard YA14 YA14 YA33 YA42 YA42 Good Practice Recommendations The registered person should ensure that service users have access to, and choose from a range of, appropriate leisure activities including an annual seven-day holiday. The registered person should ensure that television reception is adequate in all areas of the home. The registered person should review staff pay rates to ensure that they are conducive to good staff retention. The registered person should seek professional advice on the need to test the home’s emergency lighting. The registered person should ensure that hot water temperatures are close to 43°C (temperatures are too low in some areas). DS0000022747.V256597.R01.S.doc Version 5.0 Page 25 Commission for Social Care Inspection SE London Area Office Ground Floor 46 Loman Street Southwark SE1 0EH National Enquiry Line: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk © This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI DS0000022747.V256597.R01.S.doc Version 5.0 Page 26 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. 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